Grief following termination of pregnancy for fetal abnormality: does marital intimacy foster short-term couple congruence?

Abstract

Objective: This study aimed to (1) compare women and men in congruent and incongruent couples regarding the intensity of grief responses and the prevalence of clinically relevant grief responses following a termination of pregnancy for fetal abnormality; and (2) assess the role of marital intimacy in fostering couple congruence on grief responses. Background: In spite of the detrimental effects of incongruent grief on the marital relationship, previous studies have seldom compared congruent and incongruent couples. Furthermore, little is known regarding the predictors of incongruent grief. Studying such topics will allow for the implementation of effective clinical interventions aiming at decreasing the negative consequences of incongruent grief. Methods: Thirty-one couples answered the Perinatal Grief Scale and the Personal Assessment of Intimate Relationships, 1–6 months after a termination of pregnancy for fetal abnormality. Results: The majority of couples were found to display congruent grief reactions. Women had significantly more intense grief reactions than men in both groups. Women’s scores were significantly higher in incongruent couples than in congruent couples, while no such difference was found for men. Clinically relevant grief symptoms were particularly prevalent in women in incongruent couples. Women’s perception of marital intimacy, but not men’s, positively predicted couple congruence. Conclusion: Given the normativity of gender differences regarding grief responses, clinicians should foster couple communication and acceptance. As couple incongruence may signal difficulties adapting to the loss, psychological assessment is warranted. Marital intimacy is a resource for women which should be fostered in clinical interventions.

Keywords:

• couple congruence
• grief responses
• incongruent grief
• marital intimacy
• termination of pregnancy for fetal abnormality.

Acknowledgements

This study is part of the “Reproductive decisions and transition to parenthood following a pre- or postnatal diagnosis of fetal abnormality” research project, integrated in the Relationships, Development & Health Research Group of the R&D Unit Institute of Cognitive Psychology, Vocational and Social Development of the University of Coimbra (Pest-OE/PSI/UI0192/2011). Bárbara Nazaré and Ana Fonseca are supported by PhD Scholarships from the Portuguese Foundation for Science and Technology (SFRH/BD/43204/2008, SFRH/BD/47053/2008, respectively).